Project Lead(s): Gail Webber
Issue
The World Health Organization estimates that over 500 women die daily in Sub-Saharan Africa in child birth from preventable causes, with bleeding and infection being the two largest causes of maternal mortality.
In much of Africa, the majority of women deliver at home due to geographic distances, cost and cultural constraints.
Solution
Implemented in Tanzania in 2012, this project tested the acceptability and feasibility of distributing misoprostol and erythromycin (to prevent bleeding and infection) to women living in rural villages in Tanzania for them to take immediately after delivery if unable to access services at a health facility.
There were three components to the research:
• A ‘verbal autopsy’ or survey of family members of women who died in childbirth from 2007 to 2012
• Distribution of misoprostol and erythromycin to women in rural villages, with instructions on how to take them immediately after childbirth and surveys of women who used the medications
• Interviews with a sample of women who participated in the study, in addition to dispensary nurses and traditional birth attendants who attended deliveries where the medications were used.
The project provided misoprostol and erythromycin to 686 women delivering in Rorya District, Tanzania.
Outcome
The results of the study indicate that, in the population studied, more than 70% of the deliveries occurred in the villages, either at the women’s home, the traditional birth attendant’s (TBA's) home or on the way to a health facility.
Of all the women surveyed, about 90% used the study medications (including some who delivered at the dispensary where there were no other medications available); the remaining 10% appropriately received injectable medication at a healthcare facility.
The women, dispensary nurses and TBAs, were very supportive of the research and indicated that providing the medications was a positive step in helping prevent maternal deaths.
The plan is to scale up the project with modifications to the rural districts of Mara region, Tanzania. For the scale-up, the study will focus on health education to women, misoprostol distribution along with birth kits (to prevent infection in mother and baby), providing community health workers with mobile phones to collect data and register pregnant women, and stock monitoring of dispensaries.